P-06-1444 Women of North Wales have the right to have a Menopause Services Clinic in Ysbyty Gwynedd - Correspondence from the Petitioner to the Committee, 05 May 2025

I am very grateful for the responses from Carol Shillabeer and Sarah Murphy AS/MS , however I feel that they both don’t really answer the concerns again, it is a very good measured response again, but it’s still does not answers the petitions concerns and it is also a very similar response to the previous response given.

 I feel the main concern is still to be addressed, women of North Wales need a clinic in Ysbyty Gwynedd, Deeside Hospital and Wrexham Maelor and Flintshire are not central to North Wales

My reply to both letters below:

Frist one Carol Shillabeer

Below my reply to : Sarah Murphy AS/MS

I am pleased to confirm that we are progressing a number of actions led by our Clinical Lead for Women’s Services and Menopause Specialists, which will result in an increasing number of women receiving specialist menopause support in hospital clinics held closer to their homes, including at Ysbyty Gwynedd. This includes supporting more of our Consultant Gynaecologists to undertake the British Menopause Society’s Menopause Certificate that I referenced in my previous response. This is great news, how are they going to achieve this, will they be able then to offer then the statistics of how many women have been given the support in Ysbyty Gwynedd? This is great news, and it is encouraging to hear that clinics will be held at Ysbyty Gwynedd.

To date, five consultants have achieved this qualification, with a further five due to complete this training by April 2025. After this point, we anticipate that these consultants will be able to manage 90% of referrals for menopause support, with patients seen in general outpatient gynaecology clinics, with dedicated slots reserved for menopause consultations. Where? Will some be based at in Ysbyty Gwynedd?

Our three accredited menopause specialists will continue to triage all referrals, and they will provide specialist advice and support to the smaller number of women with more complex presentations. Based where, I’m sure they can travel to Ysbyty Gwynedd

As we operate a treat in turn policy, based on our Women’s Services pan North Wales capacity, some women from Gwynedd and Môn will continue to be invited to appointments at hospitals in Denbighshire, Flintshire and Wrexham, as this will ensure that they are seen more quickly, Understand the need for patients to be seen quickly, this is important but I feel that patients should be given a choice. Not everyone is able (for various reasons, access to transport, cost, logistics) to travel as far for an appointment and would like to reiterate that Ysbyty Gwynedd should be considered a key hub for this service. but why not in Ysbyty Gwynedd too?, would it not be better to cluster the women who need the service in North Wales to meet the “in turn policy ”in Ysbyty Gwynedd, therefore taking to account the patients’ needs into consideration and therefore only the one person to travel - the consultant, better for the women’s health and wellbeing anxiety etc However, an increasing number of women will be able to receive specialist menopause care at clinics delivered from Ysbyty Gwynedd. How? The petitioner, Ms Owen, may be encouraged to learn that six of the ten consultants who will soon hold the BMS certificate are based within west of our region. So does this mean 4 consultants will be based at Ysbyty Gwynedd? This is good to hear, but how does this differ “to treat in turn policy, based on our Women’s Services pan North Wales” mentioned above. This response from her is very confusing; I think she is stating that the 6 will be based West not very clear

In order to reduce appointment waiting times whilst training is being progressed, we have introduced additional face to face and virtual clinics across all three of our District General Hospitals. :is this  Denbighshire, Flintshire and Wrexham, why not Ysbyty Gwynedd?  Ysbyty Gwynedd is our central North Wales Hospital the others boarder England  not central to North Wales , women have expressed to me that face to face appointments are needed  initially and are the best option and maybe after the first appointment they may feel comfortable with a virtual service The service is also continuing to explore the option of introducing virtual sessions for GPs, in order to facilitate a clinical review of their cases and offer specialist advice, where appropriate, reducing the need for referral into secondary care. Virtual appointments do have a role to play and can be useful in terms of time efficiency both for the practitioner and the patient however, again offering the patient a choice is essential as quality of care is just as important as reducing waiting times and if people would benefit from face to face appointments then this should be strived for.

Turning to your question about Welsh language service provision, I note Ms Owen’s comments about not being asked about their language preference when attending appointments. This further highlights the importance of the ongoing monitoring exercise the service is undertaking to establish compliance with the Welsh Language Standards. As part of this exercise, the service will be working with the Health Board’s Welsh Language Team to understand current compliance and any improvement actions that are required. Simply to have a nurse present whose first language is Welsh would be adequate I feel

I am grateful for the opportunity to provide an update on the Health Board’s plans to improve its menopause service provision, and I fully acknowledge the strength of feeling about this issue among women in north west Wales. I ask that Ysbyty Gwynedd be put as part of the regional cluster of provision hospital in their pan North Wales capacity for the Women of central North Wales

I do hope that this response provides you and the petitioner with some reassurance about the Health Board’s commitment to improving access to high quality menopause care, which is delivered as close to home as possible, in line with the recently published Women’s Health Plan for Wales. This does not address the menopause care, which should be delivered as close to home as it should be, this still does not put the patient first

my reply to : Sarah Murphy AS/MS

I note in your letter you are writing to Betsi Cadwaladr University Health Board about

menopause services in North Wales.

I am aware that Betsi Cadwaladr University Health Board has been progressing a number of

improvements to its menopause services, including additional face-to-face and virtual clinics

across its three main hospital sites, and investment in training – five consultants have

completed the British Menopause Society certificate and a further five are due to complete it by the end of April. The health board is also exploring the option of introducing virtual

sessions for GPs to support a clinical review of cases and provide specialist advice without

the need to refer to secondary care. I have already answered these points in the response to Carol Shillabeer ; Ysbyty Gwynedd needs to be included as a main hospital as it is geography central for the women of North Wales, Ysbyty Gwynedd needs to be encompassed as one of the main hospitals  and not left out as it is   

Women need Face to Face for their mental health and wellbeing; patients need to be seen in person , it’s difficult in establishing connection with the patients virtually and giving quality of care an empathy engagement face to face is so important , it will make a person feel valued and listened to , virtual consolations can miss signs in body language and reading a person’s nonverbal experiences , face to face builds on a patients emotional state and trust in them feeling that they are in a safe environment to talk comfortable and not as an online patient which can build barriers in being able to be open in discussion especially if they have emotionally distressed  especially if they don’t feel comfortable sharing confidential information , they need to be mindful that not everyone can access to online services and also have limited if no skills on accessing , this again can be another barrier especially if they are anxious

Menopause is one of eight priority areas in the Women’s Health Plan, with a number of key

actions for delivery to improve the experience of women when accessing services across

Wales. Yes Menopause is “mentioned” in the women’s health plan

I am pleased to confirm an Easy Read version of the Women’s Health Plan has been

drafted and is in the final approval stage. This will be published once that approval has been

completed. Can this draft be looked at first by the women it will be supporting? Can see and make recommendations on the content etc if needed to make sure it is public money well spent before it is published?

I am determined the Women’s Health Plan will act as a catalyst for change in Wales and

ensure that there are improved health outcomes for women. I feel it needs a lot more work on it if it is to help women of Wales, seems to brush around the edges and not fully embrace the need of women

Women’s Health Plan for Wales.

· page 69 second paragraph, the wording to “manage women….” A better word and more respectful word to use would be “ to support women’s health “

· Page 70: who/what is FTWW women’s health Network? Who represents the patients?

· Page 70: Will we have access to the measurable (outcomes/information) collected against the “ women’s health dashboard? Will it show region numbers?

· Page 70 : the research to improve the understanding – how will this be done? Will they work and engage with women and how? How will the collect the mapping of the impact not only on women but the family too?  

North Wales maps :  as members can see, the cluster of the hospitals they mention are far from central to North Wales patients. This is why it is so important to have Ysbyty Gwynedd as an equal partner and not as an after thought

I would suggest that Ysbyty Gwynedd to be the Central Hospital for North Wales Menopause clinic of North Wales and the others would be satellite hubs